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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date:4s"...�..., Owner: Address • ,atlC.o°.�' Address :.• N4(5897 : /' MPATI 101 f%C B ILDING No. _ Street ;""_" _ Part t Lot _ _.{ _ _ __ Block _ _ - .. Addition or Sub -l)" on Corner Lot -_ _r .. __ Inside Lot"" _ Setback's _ _ S=y--S- Sewer Elevation _ _ _. _._ Foundation Elevation DESCRIPTION OF BUILDING TOAused. ,� Front Depth , Height Sq F't." ir"i` . Cu. Ft. _t Depth _ _ Height Sq. Ft. Cu. Ft. s Type of lfonstructlon 9IZZEst. Cost . __ To be Completed _ In consideration of the issuance to me of a permit to construct the building described above, I agree- to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. in consideration of the payment of a fee of $_ permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that theperson to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or .any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violayltozNf any of the provisions of said ordinances. i I 19F-- Building Inspector NOTICE: This permit doss not cover the construction, Installation for wiring,. plumbing, gas heating, sower or water. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FAIDLEY, MINNESOTA Owner's Name Builder Address Address LOCATION OF BUILDING / P No. Street /, Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot tom' Setback Side -Yard l� SEWR ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front 73 DepthHeight Sq. Ft. / Cu. Ft. Front Depth i Height l Sq. Ft.� Cu. Ft. l>� Type of Construction ,�/1.%r� Estimated Gosh4 To be Completed The undersigned hereby makes application for permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE - `'Z 6 " 6 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Cas Fitting Permit DepL of Bldgs. Phone SII 4-1 DESCRIPTION OF WORK Number. Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL OOT��A Number Fixtures ...................... Zrn �L, $�— Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 G Catch Basin ............................ N WATER HTR. GAq EIEC �— x 3C3 $ ' �F� m y 3F cLL NO. �'c cpm <3 U� $ `° t90 x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd 3rd — 4th • Future Connection Openings Connected withI Sewer New Fixture, Old Openings JI Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL OOT��A Number Fixtures ...................... x $1.50 �L, $�— Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) .... _.. �— x 2.00 $ ' New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ `° Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Used as To be compietea aoout Estimated Cost, $ Old—New. Building Permit No c .00W ROUGH 0,– '2 / 6 7 - FINAL a 2 2M 7-59 Apphcarion for Power Punts and Heating, Cooling, Ventilation, .Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ..... . .................. 2.00 $ Replacement of Furnace .............................. .§.00 $ Repairs & Alterations—up to $500.00 .... ............ 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ STEAM or uOM-W-ATER SYSTEM Furnace Shell & Lines—to, 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ b Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ s , OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FFtE $ ROUGH- OUGH FINAL- FINAL Dept. of Bldgs. Phone SU. City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Used as To be completed =_4z22t'_.` Estimated Cost, $ Old—New. Building Permit Noy Permit No. a.-?� DESCRIPTION/OF WORK HEATING or POWER PLANTS -Mean, Hots WA—ten Warm Air—No Trade Nam z� Size No '0 P poo Capacity Sq. Ft. E.D.$ ®y BTU /P' ' H.P. Total Connected LoaKind of Fuel BURNER — Trade Name ° ° Size No Capacity Capacity Sq. It. E.D.R BTU H.P. (REMARKS—OVER) az 2M 759 +IAT LOSS CALCULATIONS, ,r BURMAN COMPANY Weatherstrips � Construction No. Insulation uideWindows ( Doors Reference 'Out. Wall Int. Wad Cuing Roof floor Kind How Applied Yes—NO Yes�io 19_ / F1.116, d s;3�, A� Room I Lenirth ®1 ` Width -'2 o Hei$ht f- 11 1 FI_I �� � � - Rnnm I Length o -L.;- Width s 1-p— Heiizht Windows and Doors—Crachge and Area T g� �f Width Height No. 04 Lineal ft. Area No. of pane of pane lights of crack eq, ft 2r , 30 1 Net exp. wall J 0 Int. wall Floor Coef.1 Btu Infiltration 2, Required sq. ft. E.D.R.,or sq. ins. W.A. Leader area v o 1 2 -,-Vs o Glass 1 4"P ;L J? 00 Exp. wall 3 Net exp. wall 17— /V -7 0 Int. wall Floor I Ceil. =' rf 7, v I otal tstu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area i Fl.l,J)T Room I Lenath // Width V Height Windows and Doors—Crackage and Area T Infiltration Glass 2, 2..,..J Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2r , 30 1 Net exp. wall J 0 Int. wall Floor Coef.. Btu " Infiltration r Required sq. ft. E.D.R.,or sq. ins. W.A. Leader area en ej " Glass 1 Z C Exp. wall 3 Net exp. wall 17— /V -7 0 Int. wall Floor I Ceil. %0 / 7, v I otal 15tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Zuo I F1.1 R,, --r, 0 1 Room ILensath J t Width 9 t) HAght Windows and Doors—Crackage and Area T Infiltration Glass 2, 2..,..J Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2r , 30 1 Net exp. wall J 0 Int. wall Floor Coef. Btu Infiltration f �..� Required sq. ft. E.D.R.,or sq. ins. W.A. Leader area , / J' 0 Glass Z2 sr o ! p Exp. wall 6 r� J 1 Net exp. wall; J7 C, d' -7 0 Int. wall Floor I Cell. a9 / tf Total Btu. 3 � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors--Crackage and Area T Infiltration Glass 2, 2..,..J Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq: ft. 2r , 30 1 Net exp. wall J 0 Int. wall Floor Coef. Btu Infiltration' f �..� Required sq. ft. E.D.R.,or sq. ins. W.A. Leader area 666 Class Z2 sr o ! p Exp. wall / 1,. 4 4-L-- J 1 Net exp. wall J7 C, d' -102 1) Int. wall Floor I Cell. Y f / ( Total Btu. I /,/ / 6 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area W Room I Lenirth "2 Width � Heiaht Windows and Doors—Crackage and Area T Infiltration Glass 2, 2..,..J Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Exp. wall ® 7 t 1,S- t� Net exp. wall J 0 Int. wall Floor Coef. Btu Infiltsatioaa f �..� Required sq. ft. E.D.R.,or sq. ins. W.A. Leader area 666 Glass ` .S C) Exp. wall Net exp. will S Int. wall Floor Ceil.�, Total Btu. I I ` ? to Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length 1Z., Width ®a Height J Windows and Doors--Csaekage and Area Width Height I No. of Lineal ft. Area No. of pane oramne lights of crack sq. ft. m Coef.1 Btu Infiltration Glass 2, 2..,..J 6,16 Exp. wall ® 7 t 1,S- t� Net exp. wall J 0 Int. wall Floor Ceil: Total Btu. Required sq. ft. E.D.R.,or sq. ins. W.A. Leader area HEAT LOSS CALCULATIONS w -o d BRM N COMPANY WeatherstripsGJLV de 3 .5/0 d --/6 Construction No. Insulation Windows Doors Reference ' Out. Wall Int. Wall Ceiling Roof Floor Find How Applied Yes—No --Ye—s--Wo— 19_. 3 K, j-4 Exp. wall e a Net exp. wall 31 Z - ® al Vj oom I Length Width L�, Height II t FI_I - o,, a.,1 Room I Length t_ i— Width / 2— Height `- Windows and Doors—Crackage and Area d a Width Height No. of Lineal ft. Area No. of pane ofpane lights of ,r. k sq. ft. yy 3 .5/0 d Exp. wall Net exp. wall o Coef. Btu Infiltration� nfiltratloII Infiltration-72 Infiltration D O Glass Total Btu. Glass d -7 6 4) Exp. wall 3 K, j-4 Exp. wall e a Net exp. wall 31 Z - c) 7 6 Int. wall Floor Int. wall -5,4 Ceil. Int. wall /6) 776 Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area F1.1 L; 1'/ Al fir' Room I Length , k --Width 2 (— Height Windows and Doors—Crackage and Area a a Width Height No. of Lineal ft. Area No. of pale of pane lights of crack sq. ft. �4, 2� 5— eel 3 .5/0 d Exp. wall Net exp. wall o Coef. Btu Infiltration nfiltratloII Infiltration-72 Infiltration 0 Glass Total Btu. Glass d -7 6 4) Exp. wall'"00 3 K, j-4 Exp. wall e a Net cxp. wall 31 Z - Exp. wall 1 5-j J` 'I -1 Int. wall Floor Int. wall -5,4 Ceil. Int. wall Floor 776 Total Btu. I a7 e/ / : e) Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ® F1.1 !?.. Room I Lenath A f Width /° 0 Height Windows and Doors—Crackage and Area a a Width Height No. of Lineal ft. Area No.of pane of pane lights of crack sq. ft. �4, 2� 5— eel 3 .5/0 d Exp. wall Net exp. wall o Coef.1 Btu Infiltration nfiltratloII Infiltration-72 Infiltration Cell: Glass Total Btu. Glass d Exp. wall 3 K, j-4 Exp. wall e a Net exp. wall 31 Z - Exp. wall 1 5-j J` 'I -1 Int. wall Floor Int. wall -5,4 1014? 0 tj 6 Int. wall Floor Total Btu. -- _ a Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area a a 'Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq: ft. �4, 2� 5— eel 3 .5/0 d Exp. wall Net exp. wall o / 'ed i) , dt Coef. Btu nfiltratloII Infiltration-72 Infiltration Cell: a° Total Btu. Glass d r"' 3 K, j-4 Exp. wall e a n` 31 Z - Exp. wall 1 5-j J` 'I -1 Net exp. wall Net exp. wall Int. wall -5,4 1014? 0 tj 6 Int. wall Floor Ceil. t! 66 Total Btu. r Required sq. #t. E.D.R. or sq. ins. W.A. Leader area A FI_I /.i. Room f Length . / V Width _ 1'' I Height o Windows and Doors--Crackage and Area a Infiltration 0 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Glass .' . Pro I� � J Exp. wall Net exp. wall o / 'ed i) , dt 'Int. wall Coef. Btu Infiltration Cell: a° Total Btu. d Glass n` .i " 6 Exp. wall 1 5-j J` 'I -1 Net exp. wall -5,4 1014? 0 tj 6 Int. wall Floor t! .,/7 V 2, Ceil. Total Btu. I" / 32a Required sq. ft. E.D.R. or sq. his. W.A. Leader area Fl.) Room I Length 7 Width - Height Windows and Doors Crackage and Area m[Afh I sre1e1• nt.....r Te....I ft e�wa. I m Coef. Btu Infiltration 0 Glass .' . Pro I� � J Exp. wall Net exp. wall o / 'ed i) , dt 'Int. wall Floor Cell: Total Btu. Required sq. ft. E.D.R., or sq. ins. W.A. Leader area HEAT LOSS CALCULATIONS ' BURMAN COMPANY Weatherstrips � Construction No. Insulation Windows I Doors Reference 'Out. Wall Int. Wali Ceiling- Roof Floor Kind How Applied Yes—No Yes—No 19 14 11.1 ° Room I Leneth / V Width /V Height Jr II FI -I Rnnm I Lenath Width Heiuht Windows and Doors-Crackage and Area d 0 Width Height,. No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft.. 4/2— ov /'-L— CMEI Btu Infiltration CoeLl Coef. Btu InfiltrationI Net exp. wall Exp. wall d (/rj 1 1.360 Glass Ceil. Int. wall / §'0 X Exp. wall Net exp. wall Total Btu. ' Net exp. wall Int. wall 2 o p ! r� Int. wall no Ceil. Floor77— ,mellol Cell. 1 otal litu. V, Required sq. ft. E.D.R. or sq. ins. WA. Leader area FI -I A, - 1..,i Room I Length >?° Width r Height Windows and Doors—Crackage and Area d Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. > ..l ,..4 9 It e . Z e� --``, /'-L— CMEI Btu Infiltration CoeLl Btu Infiltration ; Net exp. wall Exp. wall d Glass Net exp. wall Ceil. Int. wall Exp. wall P j _y' �, Floor '° Y. r 'f ,,!"" e_.F Net exp. wall Total Btu. ' 3 -. Int. wall Floor no Ceil. Total 13tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Lenotth Width whrht Windows and Doors--Crackage and Area `� 9t�J1 p j l `� Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. > ..l ,..4 9 It e . Z e� --``, CMEI Btu Infiltration Glass Glass 22 1 7 Net exp. wall Exp. wall Int. wall Net exp. wall Ceil. Int. wall Floor '° Y. r 'f ,,!"" e_.F _ Ceil. Total Btu. ' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area T Width Height No. of Lineal ft. Area No. of pane of pane lights of crank sq: ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Floor Ceil. Total Btu. Required sq. ft E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area T Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. will Int. wan Floor. Ceil. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane ofamne I lights of crack I sq. ft. I I I —+ C6ef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Floor Ceil: Total Btu. Required sq. ft. E.D.R., or sq. ins. W.A. Leader area SUBJECT PE13643 City of Fridley AT THE TOP OF THE TWINS PERMIT BUILDING NEE EIPT `L �_____ COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 7/14/76 JOB ADDRESS 65 Rice Creek Way N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 11 1 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Daivd Cahlande r 65 Rice Creek Way N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Pine Cone Nursery, Coon Rapids 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install retaining wall 9 CHANGE OF USE FROM TO STIPULATIONS i I SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood; THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED ISNOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1'I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $1,000 WITH WHETHER SPECIFIE6 HEREIN OR NOT. THE GRANTING OF A PERMIT .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.50 PLAN CHECK FEE TOTAL FEE $8.00 SIGNATUREOF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG (NSP DATE S !NATU OF OWNER(IP OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAME:_ f ru) I Cc" -J ct• BUILDER: U_ ADDRESS ; L'7 � &-'� (2'V_ 1IC' ADDRESS: NO:. 6 < STREET: LOT: 1 \ BLOCK: ADDITION: CORNER LOT: INSIDE LOT: k SETBACK: SIDEYARD: 6 Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: i Lk -1 • ts) Front: ) 1 o Depth: 9 M Square Feet: Cubic Feet: Front: Depth: Square Feet; Cubic Feet: Height: • Height: Type of Construction: Lt)Lc,J_ loEstimated Cost: To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: 1 , 1,5 7 G SIGNATURE : (See Reverse Side For Additional Information.) s CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE y PLUMBING FIXTURE RATES: NO. >1 o a New Fixtures a 5.00 U Future Fixtures x d tr $ Water m Y 0m Bear Dispenser $ 4.00 $ H $ 5.00 $ NE p, w $ Rain Water Leader Heater 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank Yc 5.00 S Water Treating Appliance $ 7.00 $ Hot water Heater $ 5.00 $ IK -0(J Gas Range $ 10.00 .•••01111 Gas Dryer $ R R C C a O Uqqi�yq ZYPe $ U $ W N U n w H W U 4 3 �y O Elec A t�A i ql l7 t7 S 1st 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (•) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Bear Dispenser $ 4.00 $ Hlow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank S 5.00 S Water Treating Appliance $ 7.00 $ Hot water Heater $ 5.00 $ IK -0(J Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) ZYPe $ 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1t of Value of Fixture or Appliance $ State Surcharge $ .SU Reinspection Fee $ ($15.00) TOTAL FEE $I�'--!�'(/ Effective May 1, 1990. Job Address Cb/� L Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and oorrect OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT / — ( % ` Z 61- CG ESTIMATED COST o A () OLD - NEW BUILDING PERMIT NO. Company Signed B Tel. No. ROUGH INSP. Date FINAL INSP. /�-7� Date _ APPROVAL FOR PERMIT !1INIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.SO STATE SURCHARGE 9 SUBJEct PERMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING P E R M 1 T 4 8 1- 3 8 r • _____ COMMUNITY DEVELOPMENT DIV. ,,: - r � � PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEV 55432 L J\ 612-571-3450 RECEIPT 7 NUMBER 910-Ft5 11Ev DATE 10/7/98 PAGE 0: APPROVED BY JOB ADDRESS 65 Rice Creek Wa 1 LEGAL DESCR. LOT NO. 11 BLOCK 1 TRACT OR -ADDITION, Edgewater Gardcns SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Paul & Rose Ruikka 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO DAK Construction Services - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Q ADDITION ❑ ALTERATION REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 35 S Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION ZONING v SQ. FT CU FT OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES N AND OW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND DINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION SURTAX WITH ETHER SPECIFIED- INOR NOT. THE GRANTING OF A PERMIT 2999 1.50 DOES T PRESUME T GIVE UTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRO NS OF ANY AHER STA E OR LOC LAW REGULATING CON• STRUC I N OR THE PE ANC OF CONS AUCTION $74,.75 Fire S 3.00 PLAN CHECK FEE TOTAL F X) (n1-7 Ayl d bLicen C .0/ $84 5 SIG TURE OF CONTRA TOR U 4Ep ADEN* i TES P PE LIDATE T IS--YO/URS PERMIT SIGNATURE OF OW NEIL �� WNEP BUILDER �DATE� BLDG NSP - nAtE 9 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: VgXXL. A gzej-- 4��( K KA Tel. # Contractor: DA4�4 (� �C �� r MN LICENSE # Address:j�—It'd Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Le t Wid Hkt/Ground OTHER: —� Construction Type: Driveway Curb Cut Width Needed: . + 6 Ft = DATE: (�° APPLICANT• L Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ '�99 % (Fee Schedule on Back) _Fl\x $ _ $ Tel. # -),0 7:4 .1-7 Permit Fee $ ���% Fee Schedule on Reverse Side Fire Surcharge $ Q6 .001 of Permit Valuation (1/10th%) State Surcharge $ /. S-0 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 6) CD $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ O STIPULATIONS: